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Epidemiology and Clinical Characteristics of Clostridium difficile-associated Disease in Children: Comparison between Community- and Hospital-acquired Infections (소아에서 발생한 Clostridium difficile 관련 질환의 역학과 임상양상: 지역사회감염과 원내감염의 비교)

  • Cho, Hye-Jung;Ryoo, Eell;Sun, Yong-Han;Cho, Kang-Ho;Son, Dong-Woo;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.146-153
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    • 2010
  • Purpose: Recent studies have reported an increase in the incidence of community-acquired Clostridium difficile-associated disease (CA-CDAD) among children. There is an overall lack of information on CA-CDAD in the pediatric population. The aim of our study was to compare the epidemiologic and clinical features between CA-CDAD and hospital-acquired C. difficile-associated disease (HA-CDAD) in children. Methods: We retrospectively reviewed the medical records of all patients who were diagnosed with C. difficile-associated disease (CDAD) at Gil Hospital between April 2008 and March 2009. The diagnosis of CDAD was made when patients with gastrointestinal symptoms had positive results for C. difficile toxins A and B assay or stool culture. Results: Sixty-one (male, 32 and female, 29) patients were included. The mean age was 3.79${\pm}$4.54 years. Of the 61 patients, 22 (36.1%) were <1 year of age. Twenty-three patients (37.7%) had a history of antibiotic exposure in the previous 3 months. Forty-one patients (67.2%) were diagnosed with CA-CDAD. There were no significant differences in age, gender, symptoms, laboratory findings, recovery period, complications, and recurrence between the CA-CDAD and HA-CDAD groups. On the other hand, exposure to antibiotics was significantly more frequent among patients in the HA-CDAD group (p=0.005). Conclusion: This study suggests that the occurrence of CA-CDAD is increasing in the pediatric population, especially in younger children with no history of exposure to antibiotics and in outpatients. Awareness of the increasing incidence of CA-CDAD and prompt investigation of C. difficile in susceptible patients is needed to avoid misdiagnosis and for appropriate therapy.

A Clinical Observation of Children with Urachal Anomalies (요막관 기형의 임상적 고찰)

  • Lee, Sang-Bae;Jung, Chang-Hyun;Kim, Kang-Sung;Ryu, Min-Hyuk;Lee, Dong-Jin
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.213-221
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    • 2005
  • Purpose : Urachal anomalies are rare but are known to develop several complications, especially infection. Moreover, uniform guidelines for management have not been presented because of the variable clinical characteristics of these anomalies. The purpose of this report is to review our experience with urachal anomalies and attempt to determine the optimal management. Methods : We retrospectively reviewed the records of fourteen children with a variety of urachal anomalies who had been treated from January 1996 to June 2005 at Dong Kang General Hospital. Results : The age distribution of the patients(mean age; 3.8 years) was six neonates, one infant, five preschool-age and two school-age children. The male to female ratio was 1:1. Six cases of urachal cyst, four cases of patent urachus, two cases of urachal sinus and two cases of urachal diverticulum were found. Three patients with patent urachus and one with urachal cyst had hydronephrosis. Other associated anomalies included an inguinal hernia in one patient with urachal sinus and a vesicoureteral reflux in one patient with urachal diver ticulum. As a first-line diagnostic tool, high-resolution ultrasound examination was performed in thirteen cases and computed tomography in one case. Surgical excision was performed in nine patients with urachal anomaly. Five cases out of six neonatal cases experienced spontaneous improvement during a three-month follow up period. Due to frequent infection of the umbilicus, surgical excision was performed on one neonate with urachal sinus. Conclusion : All patients with urachal anomalies should undergo investigation for associated anomalies. The neonate with urachal anomalies, especially patent urachus, do not require surgical excision unless the patient has multiple episodes of recurrent infection. (J Korean Soc Pediatr Nephrol 2005;9:213-221)

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The Healing Effect of 'Self-archetype' Manifested in the Analysis of 'Hunger' and 'Compulsive Overeating' : Investigation Focused on the 'Serpent' Imago ('배고픔'과 '폭식충동'을 주소로 하는 내담자의 분석과정에서 발현된 '자기원형'의 치유적 기능 : '뱀'의 상징을 중심으로 한 고찰)

  • Kim, Kye-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.73-85
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    • 2017
  • Objectives : In this study I made investigations how 'strange hunger' and 'compulsive overeating' threatening the ego could be resolved and healed. And I aim to present a healing model of psychotherapy and analysis as one of methods of treatment for 'eating disorder'. Methods : The analysands of this study were outpatients who visited the department of psychiatry of Yong-In Mental Hospital from March 2008 to February 2017 with 'hunger' and 'compulsive overeating' as their chief complaints. This study is based on the detailed records of the process of analysis including dreams and visions. Results : 1) Throughout the process of analysis that explore both consciousness and unconsciousness(dream, vision), hunger and compulsive overeating is improved and healed in all analysands. 2) The Imago of 'Snake' appeared in dreams and visions of all analysands. 3) By suffering impulse rather than acting it out, impulse transformes itself into 'Imago'. As impulse transforms into 'Imago' and reveals the 'meaning' of it, ego-threatening power of impulse weakens and mood is calmed. And as a result, synthesis of consciousness and unconsciousness and creative transformation of personality can be possible. Conclusions : In some people, 'hunger' and 'compulsive overeating' are 'creative impulses' that aim 'Self-realization' which can be fruited as creative transformation of personality and as creative transformation in the relation with the world. 'Creative impulses', which often can be experienced as instinctive impulse or emotional suffering unless ego realizes the meaning, reveal the meaning in dreams or visions through 'Imago' and 'Symbol'.

Clinical Characteristics of Type 2 Diabetes in Children and Adolescents (소아 및 청소년 2형 당뇨병의 임상적 특징)

  • Lee, Seong Yong;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.754-763
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    • 2002
  • Purpose : The incidence of type 2 diabetes in children and adolescents has been reported to increase recently. The aim of this study is to investigate the clinical features of type 2 diabetes developing during childhood and adolescent period. Methods : The medical records of 33 patients with type 2 diabetes were reviewed. We analysed clinical manifestations, demographic data, and modes and responses of treatment. Results : Age at diagnosis was $13.4{\pm}1.8$ years. Seventy percent of patients revealed pubertal signs at diagnosis. Half of the patients had BMI more than $25kg/m^2$. Seventy-three percent of patients had family history of type 2 diabetes. Acanthosis nigricans were found in 18% of patients. Nineteen(57.6%) patients were diagnosed incidentally by random urine or blood glucose test without any typical diabetic symptom or sign. The modes of therapy to control hyperglycemia were insulin alone(75.8%), oral hypoglycemic agents alone(9.1%), insulin and oral hypoglycemia agents(9.1%), and only diet with exercise(6%). At the time of investigation, 45.5% of patients were not using insulin. The typical diabetic symptoms at diagnosis were more prevalent in patients who required insulin for more than two years than patients who did not(P<0.05). Conclusion : The development of type 2 diabetes in children and adolescents is possibly related to puberty, obesity, family history, and defects in insulin secretion rather than insulin resistance. Many children and adolescents with type 2 diabetes required insulin initially and some of them could discontinue. More than half of the patients were diagnosed as diabetes without any typical symptom or sign, which might be one of the predictive factors of the prolonged insulin requirement.

Changing Trends in the Occurrence and Management of Delirium for 5 Years in a University Hospital (일 대학병원에서 5개년간 섬망의 발생 및 치료 경향의 변화)

  • Bae, Jae Ho;Kang, Won Sub;Paik, Jong Woo;Kim, Jong Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.112-119
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    • 2012
  • Objectives : Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. Methods : We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. Results : During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). Conclusions : In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.

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The Research of Storage Capacity & Sedimentation of Reservoirs in HONAM Province (호남지방에 저수지의 매몰상황과 저수량에 관한 조사연구(농학계))

  • 이창구
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.13 no.2
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    • pp.2262-2275
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    • 1971
  • Fourteenes rervoirs maintained by the local land improvement associations in the province of Chullabuk-Do and 20 reservoir maintained by thos in the province of Chullanam-Do, were surveyed in connection with a correction between storage capacity and sediment deposit. In addition to this survey, 3,347 of small reservoir, that lie scattered around in the above-mentioned two provinces were investigated by using existing two provinces were investigated by using existing records pertaining to storage capacity in the office of City and country, respectively. According to this investigation the following comclusions are derived. 1. A sediment deposition rate is high, being about $10.63m^3/ha$ of drainage area, and resulting in the average decreasc of storage capaity by 27.5%. This high rate of deposition coule be mainly attributed to the serve denudation of forests due to disorderly cuttings of trees. Easpecially, in small reservoir, an original average design storage depth of 197mm in irrigation water depth is decreased to about 140mm. 2. An average unit storage depth of 325.6mm as the time of initial construction is decreased to 226mm at present. This phenomena causes a greater shortage irrigation water, since it was assumed that original storage quantity was already in short. 3. Generally speaking, seepage rates through dam abutment intakepipe, etc, are high due to insufficient maintenance and management of reservoir. 4. It is recommended that sediment deposit should be dredged when a reservoir is dry in drought. 5. Farmers usually waste excessive irrigation water. 6. Water saving methods should be practiced by applying only necessary water for growing stage of rice. 7. In are as where water defficiency for irrigation is severe, a soil moisture content should be kept at about 70% by applying water once in several days. 8. Tube wells should be provided so as to exploit ground water and subsurface current below stream bed as much as possible. 9. If an intake weir was constructed, a water collection well should be built for the use in drought. 10. Water conservation should be forced by converting devastated forests contained in the drainage area of reservoir to protected forests so as to take priority of yrefor estation, gully control, the prohibition of disorderly cutting of trees, etc. 11. Collective rice nurseries should be adopted, and it should be recommended that irrigation water for rice nurseries is supplied by farmer themselves. 12. Sediment desposit in reservoir should be thoroughly dreged so as to secure a original design storage capacity. 13. The structure of overflow weir should be automatic so as to freely control flood level and not to increase dam height.

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Serum Leptin Levels and Changes in Body Weight and Obesity Index in Gwacheon Elementary School Children (과천지역 초등학생의 Leptin 수준과 열량섭취, 체중 및 비만도 변화와의 관계)

  • Kim, In-Kyoung;Kang, Jae-Heon;Song, Ji-Hyun
    • Journal of Nutrition and Health
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    • v.40 no.8
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    • pp.736-744
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    • 2007
  • Leptin, as an adipocyte-derived hormone, is an important regulator of food intake and energy expenditure. In the cross-sectional study, leptin was shown to be positively related to body adiposity and metabolic disorders in adults. However, there were very few studies which reported the leptin as a predictor of weight gain over time. We examined whether serum leptin can be used as an indicator of the present and 1-year past weight status in very young children. First grade students from elementary schools in Gwacheon City were enrolled in the study since 2005. The study subjects(total 375 students; 195 boys and 180 girls) participated in the investigation of both 2005 and 2006. Physical examinations including height, weight, waist circumference were done. To examine the prevalence of obesity, obesity index was used. Serum leptin was measured, and their nutritional status was also evaluated based on 3-Day dietary records. Serum leptin levels were strongly positively related with the value of the present BMI and with the value of the BMI one year before. We found no association with leptin levels and amount of energy intake and macronutrient intake in this children population. Children were divided into three groups according to leptin tertiles. The highest leptin tertile group showed highest prevalence of obesity in year 2006 as well as in year 2005. Serum leptin levels can reflect the weight status now and as well as 1-year before. Possibly serum leptin levels can predict the weight gain of year later. Without an action against the obesity on children with high leptin level, those children would maintain the excess adiposity growth and progress into the obesity-related metabolic disorders. Further studies are needed to predict the obesity as early as possible and preventive system then after.

Investigation of a Mentor-Teacher Qualification Standard through the Analysis of Interaction in Mentoring Conversations (멘토링 대화에서 나타나는 상호작용 분석을 통한 멘토 전문성에 대한 고찰)

  • Lee, Sunduk;Go, Munsuk;Nam, Jeonghee;Lee, Sunwoo
    • Journal of The Korean Association For Science Education
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    • v.36 no.6
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    • pp.877-893
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    • 2016
  • The purpose of this study was to investigate a mentor-teacher qualification standard to support professional development for beginning secondary science teachers. The participants were four mentee teachers and four mentor-teachers. The relationship between the development of beginning science teachers teaching practice and characteristics of the mentoring and interactions was investigated by analyzing conversations between mentor and mentee teachers during the collaborative mentoring. Three mentoring conversation records and transcripts during mentoring program were collected. An analytical framework of mentoring conversations was used in the analysis of mentoring conversations and RTOP was used for lesson analysis to determine the development of teaching practice. The results show that the types of interactions during mentoring varied according to the mentoring teams. Mentors who encouraged reflective thinking induced a higher level of teaching in their mentees. The mentor qualification standard was determined from the relationship between the characteristics of the interaction and the improvement in beginning teacher's teaching practice. To be an effective mentor, the mentor should be able to 1) lead the interaction in a manner that encourages the exchange of opinions, 2) induce reflective thinking and ability to achieve reflective practice following reflective thinking, 3) provide clear explanations and suggest detailed methods, 4) lead conversations that encourage reflective thinking with questions about teaching supported techniques.

A Study on Seismic Liquefaction Risk Map of Electric Power Utility Tunnel in South-East Korea (국내 동남권 지역의 전력구 지반에 대한 지진시 액상화 위험도 작성 연구)

  • Choi, Jae-soon;Park, Inn-Joon;Hwang, Kyengmin;Jang, Jungbum
    • Journal of the Korean GEO-environmental Society
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    • v.19 no.10
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    • pp.13-19
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    • 2018
  • Following the 2016 Gyeongju earthquake, the Pohang Earthquake occurred in 2017, and the south-east region in Korea is under the threat of an earthquake. Especially, in the Pohang Earthquake, the liquefaction phenomenon occurred in the sedimentation area of the coast, and preparation of countermeasures is very important. The soil liquefaction can affect the underground facilities directly as well as various structures on the ground. Therefore, it is necessary to identify the liquefaction risk of facilities and the structures against the possible earthquakes and to prepare countermeasures to minimize them. In this study, we investigated the seismic liquefaction risk about the electric power utility tunnels in the southeast area where the earthquake occurred in Korea recently. In the analysis of seismic liquefaction risk, the earthquake with return period 1000 years and liquefaction potential index are used. The liquefaction risk analysis was conducted in two stages. In the first stage, the liquefaction risk was analyzed by calculating the liquefaction potential index using the ground survey data of the location of electric power utility tunnels in the southeast region. At that time, the seismic amplification in soil layer was considered by soil amplification factor according to the soil classification. In the second stage, the liquefaction risk analysis based on the site response analyses inputted 3 earthquake records were performed for the locations determined to be dangerous from the first step analysis, and the final liquefaction potential index was recalculated. In the analysis, the site investigation data were used from the National Geotechnical Information DB Center. Finally, it can be found that the proposed two stage assessments for liquefaction risk that the macro assessment of liquefaction risk for the underground facilities including the electric power utility tunnel in Korea is carried out at the first stage, and the second risk assessment is performed again with site response analysis for the dangerous regions of the first stage assessment is reasonable and effective.

A Documentational Study on the Development of Chi-Kung-Hak (기공학(氣功學) 발달(發達)에 관한 문헌적(文獻的) 연구(硏究))

  • Kim Woo-Ho;Hong Won-Sik
    • Journal of Korean Medical Ki-Gong Academy
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    • v.1 no.1
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    • pp.13-59
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    • 1996
  • Dep. of Classics &Medical History, College of Oriental Medicint, Kyung Hee University Today, many people are more interested Today, many people are more interested in preventing the disease than curing it. Chi-Kung(氣功) is the way of Life-Cultivation(養生法) peculiar to the orient, it is reported in china that Chi-Kung has an excellent curative value not only in curing the disease but also in preventing it. But the full-scale study of Chi-Kung is not be made up to now in Korea, so I studied the developmental history of chinese Chi-Kung through the oriental medical books. From this study, I reached the following conclusions; 1. Chi-Kung is naturally derived from the self-preservation instinct to adapt oneself to circumstances of the nature, but in the investigation from the documentational records, it is originated in the treatment method of the Sam-Huang-O-Jae(三皇五帝) period to cure the abnormal circulation of the vital force and blood caused by damp(濕). 2. As the principle and the method of the Life-Cultivation of the Chun-Chu-Jeon-Kook(春秋戰國) period were recorded in Huang-Jae-Nai-Gyung(黃帝內經) detailly and the remedy examples by ancient Chi-Kung such as Tao-Yin(導引), Haeng-Chi(行氣) were presented, we considered that theoretical basis of the development of Life-cultivation and Chi-Kung study was furnished in that period. 3. A famous doctor, Hwa-Ta(華引) lived in Han dynasty, researched the theory and practice of Tao-Yin transmitted from the former generations, as that result, he formed a kind of medical, gymnastics what is called O-Keum-Hi(五禽?). It is considered that 'O-Keum-Hi' is a Tao-Yin method developed more practically and systemetically than the Tao-Yin appeared in the 'Jang-Ja'(莊子) or 'Hoy-Nam-Ja'(淮南子). 4. In Wui-Jin-Nambook-Jo(魏曺南北朝) periods, the contents of Chi-Kung were more abundant under the influence of Buddhism(佛敎) and Taoism(道敎). Galhong(葛洪), the author of 'Po-Bak-Ja'(抱朴子) arranged the ancient Chi-Kung method systematically first of all, Tao-Goeng-Gyung, the author of 'Yang-Seong-Yeun-Myung-Rok'(養性延命錄) recorded the 'Yook-Ja-Geul'(六字訣) first time. 5. There is a new development of Chi-Kung therapy in Soo-Tang-Odae(隋唐五代) periods, especially So-Won-Bang(巢元方), the author of 'Jey-Bang-Won-Hwu-Ron' collected almost all of the Chi-Kung method, for curing the disease formed before Soo(隋) period. From that fact, we supposed that Chi-Kung was utilized more widely in curing the disease. 6. 'So-Ju-Cheon-Hwa-Hu-Peob'(小周天火候法) was adopted as the best orthodox approach under the influence of Nae-Tan-Taoist(道敎內丹學波) in Song-Keum-Won(宋金元) periods, especially in the song dynasty, 'Pal-Dan-Geum'(八段錦) was appearde and assignment of six-Chi(六氣) for bowel and viscera in the 'Yook-Ja-Geul'(六字訣) was decided firmly, that is to say Lung-Si(肺-?), Heart-Kha(心-呵), Spleen-Hoa(脾-呼), liver-Hoe(肝-噓), Kidney-chui(賢-吹), Three-Burner-shi(三焦-?). 7. In Myung-Cheong(明淸) periods, The general practitioner applied the principle of 'Byun-Jeng-Ron-Chi(辨證論治) to the Chi-Kung field, and after Myung dynasty the style of doing 'Yook-Ja-Gyel'(六字訣) was developed to the moving style. 8. Today, in china, the study on the Chi-Kyung is being progressed constantly under the positive assistance of government, Chi-Kung-Hak(氣功學) has taking its place as a branch of study step by step. It is considered that the establishment of Chi-Kung-Hak Classroom(氣功學敎室) and Medical Chi-Kung Center(氣功療法室) for special and systematic research are needed, at the same time the settlement of institutional system for training the Chi-Kung technician(氣功師) is also needed.